Monday, September 23, 2013

Recommended Treatment for Carotid Artery Disease

In my posting yesterday, I described the tests that were done confirming that my wife had carotid artery disease often times called carotid artery stenosis. The following 9 items are recommended to prevent carotid artery disease from progressing:

1. Quit smoking.
2. Control high blood pressure (optimal blood pressure is less than 120/80 mmHg).
3. Control diabetes.
4. Regular checkups with your doctor.
5. Check your cholesterol and get treatment, if necessary.
6. Eat foods low in saturated fats, trans fats, cholesterol, and salt.
7. Maintain a healthy weight.
8. Exercise at least 30 minutes most days of the week.
9. Limit alcohol to 1 drink per day for women, 2 for men.

My wife is doing all these items except quit smoking. She is a nurse and knows the health risks of nicotine, but her addiction to nicotine overpowers her sense of preventing another stroke and perhaps death. The surgery discussed below is not a valid option in our opinion since My wife is physically weak, so the risk of complications during and after surgery is great in her case.

Drugs that Can Reduce the Risk of Stroke?

Your doctor may recommend anti-platelet medications such as aspirin and clopidogrel (Plavix) to decrease the risk of stroke caused by blood clots. Your doctor may also prescribe medications to lower cholesterol and blood pressure. In some cases, Coumadin (warfarin), a blood thinner, may be prescribed in some cases.

Surgical Procedures for the Treatment of Carotid Artery Disease?

If there is severe narrowing or blockage (>70%) in the carotid artery, a procedure can be done to open the artery. This will increase blood flow to the brain to prevent future stroke. Your doctor may suggest either of the following procedures:

1.Carotid endarterectomy (CEA). This has been the commonly performed procedure for patients who have carotid atherosclerosis and TIAs or mild strokes. While you’re under general anesthesia, an incision is made in the neck at the location of the blockage. The surgeon isolates the artery and surgically removes the plaque and diseased portions of the artery. Then, the artery is sewn back together to allow improved blood flow to the brain. The risks and benefits of CEA depend on your age, the degree of blockage, and whether you’ve had a stroke or TIA.

2. Carotid artery stenting (CAS). Carotid artery stenting (CAS) is a newer treatment option. It’s less invasive than carotid endarterectomy and is performed in a catheterization laboratory. With CAS, a small puncture is made in the groin. A specially designed catheter is threaded to the area of narrowing in the carotid artery. Once in place, a small balloon tip is inflated for a few seconds to open the artery. Then, a stent is placed in the artery and expanded to hold the artery open. A stent is a small, metal mesh tube that acts as a scaffold to provide support inside your artery. The stent stays in place permanently. CAS is a newer procedure, and there is still some controversy as to how well it prevents strokes caused by carotid artery disease. If you need more detailed information read the reference website below.


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